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Gum Disease

Teeth are meant to last a lifetime.

Gum Disease Introduction

Teeth are meant to last a lifetime. Periodontal disease (previously known as Pyorrhea) is a major cause of tooth loss in our population. Most of the time, periodontal disease is preventable.

What is gum disease?

“Gum disease” describes a range of conditions that affect the supporting tissues for the teeth. The supporting tissues comprise both the surface tissues that can be seen in the mouth and also the deeper tissues of the bone, root surface and the ligament that connects the teeth to the bone.

What causes periodontal disease?

Periodontal disease is caused by bacteria. Bacteria form a ‘plaque’ which is a sticky, colourless film that forms on your teeth, particularly around the gum line. Other bacteria thrive deep in the gap between the gum and the tooth (the ‘pocket’). Some people are much more at risk of developing periodontal disease — smoking is one of the major risk factors. Other conditions such as diabetes, stress, pregnancy and various medications can all be contributing factors.

What are the most common forms of periodontal disease?

Infection affecting the surface tissues is called Gingivitis. This may progress to affect the deeper supporting tissues and is called Periodontitis (previously called pyorrhea). The effects of gingivitis are largely reversible with appropriate care. Once this has progressed to periodontitis there is permanent damage to the ligament and bone that supports and holds the teeth. Often a space develops between the gum and the tooth called a pocket. The pocket forms a protected environment for more bacteria and the condition progresses. If left untreated periodontitis may cause abscesses and tooth loss.

Can gum disease be treated successfully?

Yes.

In the vast majority of cases the progression of gum disease can be arrested with appropriate care. Management of gum disease becomes more difficult and less predictable the more advanced the disease. Therefore, the sooner periodontitis is diagnosed and treated the better. Regular dental examinations are important to check for the presence of gum disease.

The cause of gum disease is bacteria. To manage it, the bacteria must be reduced to a level the body’s defense mechanisms can handle. Treatment classically involves:

  • Achieving the best possible home care
  • Professional cleaning of the teeth above and below the gum line (into the pockets) to remove the plaque and hard deposits (calculus / tartar), and
  • Regular reviews
  • Trying to remove risk factors such as smoking.

Gum disease causes permanent damage to the supporting tissues; therefore the aim of treatment is to stop the progression of the disease through controlling the bacteria. This is an ongoing, lifelong activity.

Your general dentist is trained in managing periodontal problems. They may also use a hygienist to assist in your care. You may be referred to a Periodontist if your dentist considers your condition needs more advanced care. A specialist periodontist has gained additional qualifications and experience to satisfy the requirements of the State Dental Board and may therefore use the title “Periodontist”.

Prevention is best. To a large extent periodontitis can be prevented by good oral hygiene and early intervention when problems are identified. See your dentist regularly.

My gums bleed. Is that OK?

Infection affecting the surface tissues is called Gingivitis. This may progress to affect the deeper supporting tissues and is called Periodontitis (previously called pyorrhea). The effects of gingivitis are largely reversible with appropriate care. Once this has progressed to periodontitis there is permanent damage to the ligament and bone that supports and holds the teeth. Often a space develops between the gum and the tooth called a pocket. The pocket forms a protected environment for more bacteria and the condition progresses. If left untreated periodontitis may cause abscesses and tooth loss.

My mother lost her teeth when she was pregnant. Will that affect me?

There is no reason why a pregnancy should cause you to lose your teeth unless you ignore them totally.

During pregnancy the gums become more sensitive to bacterial irritation and may show an increased inflammation response. The type of bacteria around the teeth may also change to a type more associated with the cause of periodontitis. It is very important to maintain good oral hygiene and have regular dental checks during pregnancy.

Periodontitis can show a family tendency. So if a mother or father has periodontitis then there is an increased risk for their children to have periodontitis. Regular dental checks for periodontitis are even more important for those at higher risk for periodontitis.

A dental practitioner should check bleeding gums.

Who gets periodontitis?

Anyone.

Many people will have a small amount of periodontitis, which gradually increases with age. However approximately 15% of the population will have a significant degree of periodontitis. The destruction of the tooth’s supporting tissues caused by periodontitis gets worse over time when left untreated, and is often seen more severely in the 45+ age group. However the different types of periodontitis may affect people of all ages.

The risk for periodontitis is increased with poor oral hygiene, smoking, diabetes, a family history of periodontitis and a range of medical conditions, in particular those affecting the immune system.

What are some of the warning signs of periodontal disease?

  • Bleeding gums when you brush your teeth.
  • Bad breath or a bad taste in your mouth.
  • Receding gums.
  • Sensitive teeth or gums.
  • Loose teeth or teeth that have moved.

What can you do?

Visit your dentist, who will examine your gums as part of a normal dental check-up. X-rays are often needed to help diagnose any gum problems.

Good dental hygiene is one of the most important factors in preventing gum disease. Your dentist will show you proper brushing and flossing techniques that will help ensure healthy teeth and gums.

You may need to be referred to a Periodontist who is a specialist in treating gum disease. Treatment involves careful, deep cleaning of the teeth to remove the cause of the problem. This can be done with local anaesthetic.